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Pituitary

The pituitary MDT (Multi-Disciplinary Team) at University Hospitals of North Midlands has been in place for several years, originally set up by Professor Richard Clayton, Mr Vere Carlin and the Late Mr Jagmohan Singh.  It provides multi-disciplinary care for pituitary patients across Staffordshire and Shropshire.

Our centre has been at the forefront of adapting state of the art surgical techniques, having been one of the pioneering centres for endoscopic trans-nasal hypophysectomy. We use advanced imaging and digital navigation techniques to enhance the procedure further.

The UHNM MDT has recently developed direct links with the long-established University Hospitals of Birmingham pituitary MDT and pathology departments. We have also joined the Pituitary Foundation, thus ensuring that patients are provided with all the appropriate support throughout their journey from diagnosis to treatment.

The addition of two endocrine nurses to the team has improved the core membership and will provide direct access for patients who have a concern or question about their condition or the treatment.​

Single referral point and triage system

The referrals from UHNM specialities, GPs or outside UHNM's area are received by neurosurgery, ENT surgery or Endocrinology. All referrals are passed on to the pituitary MDT co-ordinator, who with help from the pituitary endocrinologist will prepare the patient details for discussion at the next available MDT meeting. Patients may be contacted for pituitary blood tests, visual field tests and further scans before the case details can be discussed at the MDT meeting.

Well-established monthly P​​​ituitary MDT Meeting

All cases referred to UHNM are discussed at the monthly multi-disciplinary meeting, usually on the first Monday of every month. The meeting is attended by the pituitary endocrinologists, neurosurgeon, ENT surgeon, neuroradiologists and pituitary nurses in addition to trainees in the attending specialities.

The MRI scans, visual field results and pituitary bloods are reviewed at the meeting and a joint decision is taken after considering all clinically relevant information in each individual case. Those who need surgery are brought to the joint clinic attended by the endocrinologists and pituitary surgeons.

Pituitary su​​rgery

Transnasal Endoscopic Hypophysectomy
Transcranial Hypophysectomy

Endocrinology o​​​ut-patient clinic

For those who do not require surgery, follow-up is arranged from the endocrinology out-patient clinics to monitor the tumour and pituitary function.

Radiot​​herapy

Those patients with recurrent or refractory pituitary disease often need radiotherapy to the pituitary gland. The MDT has direct access to clinical oncology services at UHNM to organise assessment.

Ophthalmology

Pituitary adenoma and other sellar tumours can affect vision by exerting pressure on the nerve pathways of vision. The MDT is supported by the ophthalmology services at UHNM.

Medical Investi​​gation Unit

This service is run by our trained endocrine nurses, who also support the pituitary MDT as core members in their role as pituitary nurses. All specialised endocrine blood investigations, pituitary assessments, and clinical reviews are arranged by the nurse team. The endocrinology registrars review all post-pituitary surgery patients and arrange post-operative pituitary tests and MRI scans.

Pituitary Nurse Support

Two dedicated pituitary nurses are available to provide a focal contact point for the pituitary patients. Patients can contact the pituitary nurses directly for advice on their condition and any concerns they have about their health. The nurses are supported by consultants and registrars in endocrinology who can provide urgent input by telephone or in out-patient clinics as required.